Provider Demographics
NPI:1477924694
Name:GILLIES, LINDSEY ANNE (CNM, WHNP-BC, CPM)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ANNE
Last Name:GILLIES
Suffix:
Gender:F
Credentials:CNM, WHNP-BC, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 VINE ST
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:VT
Mailing Address - Zip Code:05641-4035
Mailing Address - Country:US
Mailing Address - Phone:631-742-1872
Mailing Address - Fax:
Practice Address - Street 1:15 VINE ST
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:VT
Practice Address - Zip Code:05641-4035
Practice Address - Country:US
Practice Address - Phone:631-742-1872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT107.0109141176B00000X
MARN2337172363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No176B00000XOther Service ProvidersMidwife